Adaptation of a Synergy Model-based Patient Acuity Tool for the Electronic Health Record
Authors:
- Mei Lin PhD Chen-LimMCMei Lin PhD Chen-Lim
- Halley RuppelHRHalley Ruppel
- Walter FaigWFWalter Faig
- Eloise Mlis FloodEFEloise Mlis Flood
- Daniel MeadDMDaniel Mead
- Darcy Bs BrodeckiDBDarcy Bs Brodecki
- 17 March 2025
- journal article
- research article
- Published by Wolters Kluwer Health in CIN: Computers, Informatics, Nursing
- Vol. 43 (9)
Abstract
Nurse staffing decisions are often made without input from high-quality, reliable patient acuity measures, especially in medical-surgical settings. Staffing decisions not aligned with patient care needs can contribute to inadequate patient-to-nurse ratios and nurse burnout, potentially resulting in preventable patient harm and death. We conducted a proof-of-concept study to explore the feasibility of adapting an evidence-based patient acuity tool for use in the EHR. A retrospective cohort of pediatric medical-surgical inpatients was used to map electronic patient data variables. We developed an algorithm to calculate the score for one domain of the tool and validated it by comparing it with a score based on a manual chart review. Through multiple rounds of testing and refinement of the variables and algorithm, we achieved 100% concordance between scores generated by the algorithm and the manual chart review. Our proof-of-concept study demonstrates the feasibility and challenges of adapting an evidence-based patient acuity score for automation in the EHR. Further collaboration with data scientists is warranted to operationalize the tool in the EHR and achieve an automated acuity score that can improve staffing decisions, support nursing practice, and enhance team collaboration.Keywords
This publication has 41 references indexed in Scilit:
- Voices from frontline nurses on care quality and patient safety during COVID-19: An application of the Donabedian modelAmerican Journal of Infection Control, 2023
- Development and Validation of a Machine Learning Algorithm Using Clinical Pages to Predict Imminent Clinical DeteriorationJournal of General Internal Medicine, 2023
- Validation of a Proprietary Deterioration Index Model and Performance in Hospitalized AdultsJAMA Network Open, 2023
- Engaging Frontline Nurses in Building an Electronic Workload Acuity ToolNurse Leader, 2023
- Natural Language Processing in Electronic Health Records in relation to healthcare decision-making: A systematic reviewComputers in Biology and Medicine, 2023
- Measure to improve: Is there a patient‐acuity measurement tool suitable for use in maternity service provision in the Netherlands? A systematic reviewHealth Science Reports, 2022
- A data preparation framework for cleaning electronic health records and assessing cleaning outcomes for secondary analysisInformation Systems, 2022
- Nurse staffing levels and patient outcomes: A systematic review of longitudinal studiesInternational Journal of Nursing Studies, 2022
- Nursing workload, nurse staffing methodologies and tools: A systematic scoping review and discussionInternational Journal of Nursing Studies, 2020
- Nurse–patient assignment models considering patient acuity metrics and nurses’ perceived workloadJournal of Biomedical Informatics, 2015